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Kidney donors can reduce wait for loved one on transplant list

DENVER >> Coloradans who are interested in donating a kidney, but concerned it would leave them unable to help if a family member later got sick, have an option to get a “voucher” to shorten a loved one’s wait if they need a transplant.

People who donate a kidney while still alive long have been prioritized for transplants, should they ever need one. The voucher system giving priority to up to five loved ones is newer and not as well known, though, and not every transplant center offers the option.

Tyler Coleman was the first person in Colorado to give a kidney through the voucher system in 2019. The Denver resident said he’d heard about living donation before, but hearing donors’ stories with his wife, Jessica Coleman — living donor coordinator for Centura Health — convinced him it was something he wanted to do.

He opted to list his wife, who has Type 1 diabetes, and their son Ryker, 4, as potential voucher recipients. People with diabetes are at an increased risk of kidney disease. As far as they know, Ryker is at average risk of kidney disease in adulthood. But since he’s adopted, if he ever does need a transplant he might not know someone who’s a close genetic match.

Dr. Alex Wiseman, executive director of kidney transplantation at Centura Health, said people who are willing to be donors sometimes hesitate because they want to save their kidney in case a family member or friend needs it. The voucher gives them some security to donate to someone in need now, he said.

Transplants from living donors generally produce better results, because there’s time to do extensive planning and testing, Wiseman said.

But not everyone has a relative with a compatible blood type who is healthy enough to donate and willing to do so.

“A lot of people don’t have that network, so they wait” for a deceased donor, he said. “People like Tyler are helping people who don’t have that network.”

The voucher essentially gives a person credit for four years spent on the waiting list, Wiseman said. In Colorado, wait times for a deceased donor’s kidney can range from two to four years for people with blood type AB, and six to seven years for people with blood type O. (People with type AB blood can receive kidneys from donors with blood type A, B, AB or O, while recipients with type O need a donor with the same blood type.)

In 2014, the University of California, Los Angeles’ health centers were the first to offer vouchers. The first donor was a man whose grandson had a condition that might require a kidney transplant later in life. The grandfather wanted to offer his kidney, but knew he might not be healthy enough to do so by the time the boy needed it, said Dr. Jeffrey Veale, a transplant surgeon and professor of urology at UCLA. The voucher allowed the grandfather to feel comfortable giving his kidney to another person in need.

“The voucher kind of liberates us to give (the kidney) to the next person,” Veale said.

A relatively small share of kidney donations involve a voucher, but the number is expanding steadily. Nationwide, vouchers were involved in 22 donations in 2018 and 113 in 2020, Veale said. And the average donation starts a “train” of other donations, as recipients’ relatives who had the wrong blood type to help their loved one give to someone else, he said.

So far, only six vouchers nationwide have been redeemed — perhaps not surprising, since kidney disease typically develops over years or decades. Those who have received a kidney after using a voucher waited between one and five months. But a voucher doesn’t guarantee any specific time frame for waiting, since a transplant can’t happen until a compatible organ becomes available.

While donors can list up to five people for a voucher, only one can use it, Veale said.

“You put one into the system and you take one out,” he said.

Nationwide, more than 41,000 organs were transplanted in 2021, for a roughly 6% increase compared to 2020. In Colorado, 642 organs were transplanted last year, a 9% increase. Kidneys were the most commonly transplanted organ, followed by livers and hearts.

About 106,000 people are waiting for organs, according to the Health Resources Services Administration, and roughly 90,000 of them need a kidney. That’s an improvement from 2020, when about 113,000 people were waiting. Some of that improvement is attributed to skyrocketing drug overdose deaths, increasing the number of deceased donors, but living donations have also increased, Veale said.

Tyler Coleman said he has no regrets about donating. The hardest part, he said, was deciding when to do it, since he had to take time off from work and wasn’t allowed to lift his son for a few weeks.

He estimated he was home from the hospital in about 36 hours and recovered in about two weeks. He later learned his kidney went to a man in Chicago, and he was able meet the recipient and his family.

“To put it lightly, it’s worth it,” he said.

People interested in living kidney donation can start the screening process at KidneyRegistry.org.

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